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Individual

MARY MADISON BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., BCBA

Contact information

Practice address
2053 EXPERIMENT STATION RD, WATKINSVILLE, GA 30677-5326
(334) 792-5020
Mailing address
1055 BAXTER ST APT 308, ATHENS, GA 30606-3777
(251) 363-3835

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-76894
106S00000X
Behavior Technician
22-204355
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22-204355
22-204355
AL
Enumeration date
02/25/2022
Last updated
11/11/2024
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